Rydman R J, Zalenski R J, Roberts R R, Albrecht G A, Misiewicz V M, Kampe L M, McCarren M
Department of Emergency Medicine, Cook County Hospital, Chicago, IL, USA.
Ann Emerg Med. 1997 Jan;29(1):109-15. doi: 10.1016/s0196-0644(97)70316-0.
Patient satisfaction is an essential outcome measure in the diagnosis and treatment of acute chest pain in the emergency department. We compared patient satisfaction with the diagnostic protocol of a chest pain observation unit (CPOU) and standard inpatient hospitalization.
We prospectively studied patients who presented to the ED with chest pain and were found to have a low risk of acute myocardial infarction (AMI) but who still might have benefited from a diagnostic protocol to rule out AMI. Consenting patients (N = 104) were randomized to the CPOU (experimental) arm or the hospital inpatient (control) arm and assessed for satisfaction by means of an interview before hospital discharge.
The CPOU protocol scored higher on four summary ratings of overall patient satisfaction. Correlations between overall satisfaction, number, and type of problems with care, and patient characteristics demonstrated content validity and revealed strengths and improvements that might be made in CPOUs.
Patients were more satisfied with rapid diagnosis in the CPOU than with inpatient stays for acute chest pain. Our findings add important information to the standard practice of weighing clinical and cost outcomes between two medical care alternatives.
患者满意度是急诊科急性胸痛诊断与治疗中的一项重要结果指标。我们比较了患者对胸痛观察单元(CPOU)诊断方案和标准住院治疗的满意度。
我们前瞻性研究了因胸痛就诊于急诊科且被发现急性心肌梗死(AMI)风险较低但仍可能从排除AMI的诊断方案中获益的患者。同意参与的患者(N = 104)被随机分配至CPOU(试验)组或医院住院(对照)组,并在出院前通过访谈评估其满意度。
CPOU方案在患者总体满意度的四项综合评分上得分更高。总体满意度、护理问题的数量和类型以及患者特征之间的相关性证明了内容效度,并揭示了CPOU可能存在的优势和有待改进之处。
与急性胸痛住院治疗相比,患者对CPOU的快速诊断更满意。我们的研究结果为在两种医疗护理选择之间权衡临床和成本结果的标准做法增添了重要信息。